Podcast Link: SGEM207 Date: February 14th, 2018 Reference: Alam N et al. Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. The Lancet Nov 2017. Guest Skeptics: Jay Loosley is the Superintendent of Education at Middlesex-London Paramedic Service. Jenn Doyle is a paramedic educator at Middlesex-London Paramedic Service. Case: EMS is dispatched to a retirement home. They have a 73-year-old man who complains of weakness and a cough for the last 48 hours. You arrive and find the man lying in bed looking ill. He has a history of hypertension, benign prostatic hypertrophy and osteoarthritis. His medications include ramapril, hydrochlorothiazide and tamsulosin. On examination, he has a temperature of 38.7C, heart rate of 105 beats per minute, respiratory rate of 26, oxygen saturation of 88%. and a blood pressure of 88/50 mmHg. You load him on the stretcher,...

Podcast Link: SGEM206a Date: February 6th, 2018 Reference: Foster SJ et al. Oral prednisolone in preschool children with virus-associated wheeze: a prospective, randomised, double-blind, placebo-controlled trial. Lancet January 2018 Guest Skeptic: Dr. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. She is also the co-founder of Don’t Forget the Bubbles and on the FeminEM Speaker Bureau. Case: Tom is a 4-year-old boy who comes into the emergency department with a wheeze following a viral illness. He has been taking salbutamol at home today but he’s still not improving. He has mild work of breathing and a bilateral wheeze. His oxygen saturation is 94% on room air. Tom has no other previous medical history. You start to write up the salbutamol, but should you give him a dose of prednisolone too? Background: We see “little wheezers”...

Podcast Link: SGEM205 Date: January 31st, 2018 Reference: Frohlich LC, et al. Prospective validation of clinical score for males presenting with an acute scrotum. AEM Dec 2017. Guest Skeptic: Dr. Melissa Langhan is an Associate Professor of Pediatric Emergency Medicine at Yale University in New Haven, CT. Melissa is passionate about clinical and translational research and focuses most of her work on the use of capnography or end-tidal carbon dioxide monitoring. In her spare time, Melissa also enjoys being the fellowship director to an amazing group of PEM trainees. Case: Brian is a 14-year-old male who presents to the emergency department (ED) complaining of acute onset testicular pain. He has vomited twice, but there is no history of any fever or trauma. On examination, you find a firm, swollen right testicle, and the cremasteric reflex is notably absent on that side. Your index of...

Podcast Link: SGEM204 Date: January 25th, 2018 Reference: Hawkins et al. Peripheral Intravenous Cannula Insertion and Use in the Emergency Department: An Intervention Study. AEM Jan 2018 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency. Case: You are caring for a patient with a fever in the emergency department and the nurse asks if you want to start an intravenous (IV) line or just draw blood. You think for a minute…your patient is not tachycardic, not vomiting, and the likelihood of discharge is very high. Background: Emergency department patients often have peripheral IV cannula (PIVC) placed at triage for initial blood draws or “just in case” they are used during the emergency department stay or hospitalization. It is one of the most commonly performed procedures in the emergency department. PIVC placement...

Podcast Link: SGEM Xtra Eight Days a Week Date: January 26th, 2018 Happy New Years again SGEMers. This is just a quick SGEM Xtra episode to let you know what I am going to be trying to do in 2018 to help you cut the knowledge translation (KT) window down from over ten years to less than one year. It involves following a weekly schedule of social media interaction. Weekly SGEM Schedule Saturday/Sunday SGEM: A new episodes of the SGEM will be posted most Saturdays or Sundays depending on my schedule. The blog will be about 2,ooo words in length that you can read while drinking your morning coffee. Or you can listen to the 20-30 minute podcast on iTunes while working out or turn your car into a classroom while traveling to your next shift. The ultimate goal of the SGEM cutting...

Podcast Link: SGEM203 Date: January 15th, 2018 Reference: Sadeghirad B, et al. Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials. BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. She has contributed to the Academic Life in Emergency Medicine and EM PharmD blogs, and is a part of the ALiEM Capsules Team. Case: 50-year-old man presents with a one day history of sore throat, cough and low-grade fever. He is otherwise healthy with only sports related injuries. The ibuprofen did not help and he is requesting antibiotics so he can get back to work sooner. Background: Patients present commonly to their primary care providers (PCPs) and to the emergency department (ED) with complaints of a sore throat. In the US, adults accounted for 6.6 million visits...